<div align="center" >
	<div align="left" class="portlet">
		
									<table width="100%" border="0">
				<tbody><tr>
					<td width="20%"><strong>Nomor Surat</strong></td>
					<td width="80%"><i  id="tpl_no_srt"></i>
&nbsp;*</td>
				</tr>
				<tr>
					<td><strong>Tanggal Surat</strong></td>
					<td><i id="tpl_tgl_srt"></i>
&nbsp;*</td>
				</tr>
								<tr>
					<td><strong>Cabang Afiliasi</strong></td>
					<td>
					  <i id="tpl_id_afiliasi"></i>
					</td>
				  </tr>
							
			</tbody></table>
			
			<div style=" ">
				<table width="100%">
					<tbody><tr>
						<td width="50%" valign="top">
							<table>
								<tbody><tr>
									<td><label for="to">To</label></td>
									<td><i id="tpl_to"></i>
</td>
								</tr>
								<tr>
									<td><label for="to_attn">Attn</label></td>
									<td><i id="tpl_to_attn" ></i>
</td>
								</tr>
								<tr>
									<td><label for="to_address">Address</label></td>
									<td><i id="tpl_to_address" ></i>
</td>
								</tr>
							
								<tr>
									<td><label for="to_telp">Tel.</label></td>
									<td><i id="tpl_to_telp" ></i>
</td>
								</tr>
								<tr>
									<td><label for="to_fax">Fax.</label></td>
									<td><i id="tpl_to_fax" ></i>
</td>
								</tr>
								<tr>
									<td><label for="to_email">Email</label></td>
									<td><i id="tpl_to_email" ></i>
</td>
								</tr>
							</tbody></table>
						</td>
						<td width="50%" valign="top">
							<table>
								<tbody><tr>
									<td><label for="from">From</label></td>
									<td><i id="tpl_from" ></i>
</td>
								</tr>
								<tr>
									<td><label for="from_attn">Attn</label></td>
									<td><i id="tpl_from_attn" ></i>
</td>
								</tr>
								<tr>
									<td><label for="from_address">Address</label></td>
									<td><i id="tpl_from_address" ></i>
</td>
								</tr>
							
								<tr>
									<td><label for="from_telp">Tel.</label></td>
									<td><i id="tpl_from_telp" ></i>
</td>
								</tr>
								<tr>
									<td><label for="from_fax">Fax.</label></td>
									<td><i id="tpl_from_fax" ></i>
</td>
								</tr>
								<tr>
									<td><label for="from_email">Email</label></td>
									<td><i id="tpl_from_email" ></i>
</td>
								</tr>
							</tbody></table>
						</td>
					</tr>
				</tbody></table>
			</div>
				
			<table width="100%" border="0">
				<tbody><tr>
					<td width="20%"><label for="subject">Subject</label></td>
					<td width="80%"><i id="tpl_subject" ></i>
</td>
				</tr>
				<tr>
					<td><label for="name">Nama</label></td>
					<td><i id="tpl_name" ></i>
</td>
				</tr>
				<tr>
					<td><label for="subject_oi">Subject of Inspection</label></td>
					<td>
						<i id="tpl_subject_oi" ></i>
					</td>
				</tr>
				<tr>
					<td><label for="description_og">Description of Goods</label></td>
					<td>
						<i id="tpl_description_og" ></i></td>
				</tr>
				
			</tbody></table>
			
			<div style="padding:4px;border-top:1px solid #dedede;border-bottom:1px solid #dedede; margin-top:5px; margin-bottom:5px;">
				<table width="100%">
					<tbody><tr>
						<td width="50%" valign="top">
							<table>
								<tbody><tr>
									<td colspan="2"><h4>Importer</h4></td>
								</tr>
								<tr>
									<td><label for="importer">Company Name</label></td>
									<td>
										<i id="tpl_importer" ></i>
									</td>
								</tr>
								<tr>
									<td><label for="importer_attn">Attn</label></td>
									<td><i id="tpl_importer_attn" ></i>
</td>
								</tr>
								<tr>
									<td><label for="importer_address">Address</label></td>
									<td><i id="tpl_importer_address" ></i>
</td>
								</tr>
						
								<tr>
									<td><label for="importer_telp">Tel.</label></td>
									<td><i id="tpl_importer_telp" ></i>
</td>
								</tr>
								<tr>
									<td><label for="importer_fax">Fax.</label></td>
									<td><i id="tpl_importer_fax" ></i>
</td>
								</tr>
								<tr>
									<td><label for="importer_email">Email</label></td>
									<td><i id="tpl_importer_email" ></i>
</td>
								</tr>
							</tbody></table>
						</td>
						<td width="50%" valign="top">
							<table>
								<tbody><tr>
									<td colspan="2"><h4>Exporter</h4></td>
								</tr>
								<tr>
									<td><label for="exporter">Company Name</label></td>
									<td><i id="tpl_exporter" ></i>
</td>
								</tr>
								<tr>
									<td><label for="exporter_attn">Attn</label></td>
									<td><i id="tpl_exporter_attn" ></i>
</td>
								</tr>
								<tr>
									<td><label for="exporter_address">Address</label></td>
									<td><i id="tpl_exporter_address" ></i>
</td>
								</tr>
								
								<tr>
									<td><label for="exporter_telp">Tel.</label></td>
									<td><i id="tpl_exporter_telp" ></i>
</td>
								</tr>
								<tr>
									<td><label for="exporter_fax">Fax.</label></td>
									<td><i id="tpl_exporter_fax" ></i>
</td>
								</tr>
								<tr>
									<td><label for="exporter_email">Email</label></td>
									<td><i id="tpl_exporter_email" ></i>
</td>
								</tr>

							</tbody></table>
						</td>
					</tr>
				</tbody></table>
			</div>
			
			<table width="100%" border="0">
				<tbody><tr>
					<td width="20%"><label for="place_oi">Place of Inspection</label></td>
					<td width="80%"><i id="tpl_place_oi" ></i>
</td>
				</tr>
				<tr>
					<td><label for="date_oi">Date of Inspection</label></td>
					<td><i id="tpl_date_oi" ></i>
</td>
				</tr>
			</tbody></table>
			
			<div style="padding:4px;border-top:1px solid #dedede;border-bottom:1px solid #dedede; margin-top:5px; margin-bottom:5px;">
				<h2>References</h2>
				<table width="100%">
					<tbody><tr>
						<td width="20%"><label for="import_permit_no">Import Permit No</label></td>
						<td width="80%"><i id="tpl_import_permit_no" ></i>
</td>
					</tr>
					<tr>
						<td><label for="invoice_no">Invoice No</label></td>
						<td><i id="tpl_invoice_no" ></i>
</td>
					</tr>
					<tr>
					  <td><label for="quotation_no">Quotation No</label></td>
					  <td><i id="tpl_quotation_no" ></i>
</td>
				  </tr>
					<tr>
					  <td><label for="quotation_date">Quotation Date</label></td>
					  <td><i id="tpl_quotation_date" ></i>
</td>
				  </tr>

				</tbody></table>
			</div>

			<div style="padding:4px;border-bottom:1px solid #dedede; margin-top:5px; margin-bottom:5px;">
				<h2>Company</h2>
				<table width="100%">
					<tbody><tr>
						<td width="20%"><label for="company_name">Nama</label></td>
						<td width="80%"><i id="tpl_company_name" ></i>
</td>
					</tr>
					<tr>
						<td><label for="company_npwp">NPWP</label></td>
						<td><i id="tpl_company_npwp" ></i>
</td>
					</tr>
					<tr>
						<td><label for="company_address">Alamat</label></td>
						<td><i id="tpl_company_address" ></i>
</td>
					</tr>
				</tbody></table>
			</div>
			<div style="padding:4px;margin-top:5px; margin-bottom:5px;">
				<table width="100%">
					<tbody><tr>
						<td width="20%"><label for="regard">Regards, </label></td>
						<td width="80%"><i id="tpl_regard" ></i>
</td>
					</tr>
					<tr>
						<td><label for="applicants_name">Applicant's Name</label></td>
						<td><i id="tpl_applicants_name" ></i>
</td>
					</tr>
				</tbody></table>
			</div>
	</div>
</div>